Lyme disease is a complicated, multi-staged illness that is poorly understood and often exists with other poorly understood tick-borne illnesses. Uncertainties about these infections cause plenty of confusion and variations in how different groups use disease terms adds to it. Let’s take a minute to make sure we’re on the same page, so to speak.

“Lyme disease”, as frequently used by the media and many physicians, refers to an acute or untreated infection caused by the bacterium Borrelia burgdorferi.

Many patients, treating physicians and Lyme disease advocates use the term differently. To them, “Lyme disease” is also a shorthand term for the complex and variable illnesses experienced by patients with persistent or multiple tick-borne infections.

On this website, “Lyme disease” refers to illnesses due to an infection by any one of several infectious species of Borrelia. Issues relevant to a specific stage of Lyme disease will be noted accordingly.

“Chronic Lyme” is an especially confusing and controversial term. Some use it to describe any infection that has gone on for several months. Others us it to describe patients who were treated for Lyme disease but remain ill. A third group uses this…

Lyme disease is a bacterial infection that may develop after a bite from a Lyme-infected blacklegged tick. The CDC estimates that more than 300,000 new cases of Lyme disease occur each year in the US but only a fraction of these cases are reported to public health officials.

Lyme Awareness: Risk

Many areas of the country are at high risk for Lyme disease. Wooded or forested regions that provide suitable tick habitat are especially at risk and breaking these areas into smaller parcels increases that risk. This map depicts where blacklegged ticks are commonly found.

People who live/work/recreate in Lyme-endemic areas or tick habitat may be exposed to disease carrying ticks in a variety of settings – campsites, parks, golf courses, sports fields, and their own back yards. Pet ownership is associated with an increased risk of Lyme disease. Age-related risk is greatest in school-aged kids and lowest in young adults.

Lyme Awareness: Disease basics

Lyme infections can cause a significant illness for some, producing serious and chronic symptoms that result in substantial short- and long-term disabilities. Lyme disease is multi-staged but not every patient experiences each stage. A wide variety of symptoms are…

It isn’t always easy to know who has or doesn’t have Lyme disease. Lab tests are often unreliable and patients with Lyme disease don’t have a certain “look”. There are many individual features that vary from patient to patient and most are not highly distinctive. This means that doctors are looking for patient images that lack the sharp lines of a photograph and instead look more like a painting.

The articles in this section describe the “art” of making (or not making) a Lyme diagnosis. They discuss the specific elements doctors search for and consider when determining whether or not a patient has Lyme disease.

A Clinical Diagnosis

It is often said that Lyme disease is a clinical diagnosis; this is an important concept to understand. The term “clinical diagnosis” means that doctors decide whether or not a disease is present based on information obtained during patient visits and not on the basis of test results. Making a diagnosis on clinical grounds isn’t unique to Lyme disease. Some diseases lack tests that reliably identify the ill. In others, the costs associated with testing – money, time, discomfort or the potential for harm – outweigh the…